Interdisciplinary Care

Crozer-Keystone Health System nurses collaborate on numerous system-wide multidisciplinary teams each year. View the information below to read about a few of the many examples.

Critical Test Results Reporting Time Reduced

In 2007, nursing was a key player in a system-wide multidisciplinary team that collaborated to reduce the turnaround time for reporting critical lab test results, a performance indicator on the CKHS Nursing Dashboard. The team also included representatives from the Laboratory, Respiratory, Radiology and Cardiology as well as physicians. After establishing what constitutes a critical test and a critical result, the team set a targeted turnaround time of 60 minutes or less.

The Nurse Practice Council developed a critical test result audit form to be completed by the nurse, tracking the timeline from the physician’s initial order of the test through the time the physician receives the RN’s phone call with the result. In March 2007, the laboratory manager at each hospital began sending nurse managers a daily report of patients who had a critical result within the past 24 hours. Each month, the nurse managers audit critical test results, which are posted on the unit and discussed at unit staff meetings to raise awareness and ensure compliance. All CKHS hospitals more than met the system goals of a 60-minute turnaround and 90 percent compliance in FY 2008. (See figure below.) In some cases, turnaround time was cut in half.

Ave. Time (mins.)Report from RN to Physician

Percentage Compliance

Report within 60 mins.

Crozer

13

97%

DCMH

23

96%

Springfield

11

96%

Taylor

16

90%

CKHS

16

93.5%

Nurses Play Key Role in Community Hospital’s Behavioral Health Program

Community Hospital’s Behavioral Health Program annually serves about 2,400 patients through case management, adult outpatient psychotherapy, psychiatric rehabilitation, a substance abuse program, Methadone clinic, geriatric program and sex offenders program. Seven nurses are key players on the Behavioral Health Program’s multidisciplinary team, which also includes case managers, physicians, social workers, psychologists and psychotherapists under the leadership of Kevin P. Caputo, M.D., chairman of Psychiatry at Crozer-Chester Medical Center and Taylor Hospital and president of Community Hospital.

Nurses bring unique and valuable skills to the table, according to Terri Venello, RN, director of Outpatient Adult Services. “We think in terms of recovery, and our nurses have had some great successes. In addition to providing direct patient care as psychotherapists and rehabilitation practitioners, our staff nurses participate on quality monitoring committees that identify quality indicators to be monitored as well as practice issues to be addressed,” she explains.

One such practice issue is the client follow-up protocol, which nurses helped to develop for Community’s Behavioral Health Program. Within 48 to 72 hours of receiving a client referral from a physician, a designated therapist must make contact with the client. The therapist will make two attempts to engage the client in treatment. If a client misses an appointment, the therapist follows up. “Calling clients after missed appointments is one of our quality indicators,” notes Venello. If a client pulls away from treatment, the therapist must make two attempts to reengage that individual.

“We empower clients to make choices regarding therapy, and some may choose to stop coming or not to come in the first place,” says Venello, “but we want to make sure that no one falls through the cracks because we haven’t followed up properly.”

From left to right: Linda Cephas, Paul O’Laughlin, Michele Patton and Terri Venello.